While controversy rages over building hazardous waste incinerators in Utah, incinerators are stoked up every day in residential areas, burning plastic syringes and other infectious waste.
They are the preferred method of disposal for several hospitals that must get rid of used bandages, blood vials, body parts, syringes, gauze pads and other waste, some of it infected by the AIDS or hepatitis viruses.Assuming they work as designed, incinerators are a great way to destroy bulky and dangerous material.
Smaller medical facilities - which could include veterinarians' offices, clinics, blood banks, morticians, private employers with first-aid stations, and doctors' offices - contract with a commercial shipper to haul the material to an out-of-state incinerator.
But some dispose of infectious material in dumpsters; no law forbids it.
LDS Hospital has an approved incinerator on its grounds. It uses a "red bag system," so all infectious waste goes into red bags separate from the hospital's normal disposal system.
Then they are burned in a dual-chamber incinerator on the hospital's grounds.
Bill Lukens, the hospital fire marshal and safety officer, said the burner was approved by the Environmental Protection Agency.
The main chamber burns natural gas at 1,500 to 1,800 degrees Fahrenheit, depending on the type of material being incinerated. Then the afterburner, located above the main chamber, burns the smoke at 1,000 to 1,200 degrees, assuring the destruction of any pathogens.
"It burns everything right out of it so that when smoke comes out of the top of the chimney the smoke is clear and there's is not biological waste in it - no waste at all."
Lukens said hospital and state health officials check the incinerator to make sure it's operating at the proper temperatures.
About 90 percent of syringes and intravenous tubes are plastic, and they are annihilated by the searing temperature. Contaminated needles undoubtedly glow white-hot, and when the burning cycle is over in two or three hours, they are like pot metal - apt to crumble when handled, devoid of germs.
"We could put several hundred pounds of material in the incinerator at a time," Lukens said. The decontaminated ash is taken to a landfill.
The incinerator runs in cycles, and the hospital hopes to someday build a new unit that would allow a continuous feed. LDS Hospital officials would like to see a regional incinerator built for use of all the hospitals in the parent corporation, Intermountain Health Care.
Hospitals and clinics that don't have their own incinerators once sent infectious waste to hospitals that had them. But that was back when much hospital material was reused, such as syringes and thermometers. Even needles were sterilized and reused.
Today, the disposable unit is king: use it once and throw it out. That's more sanitary, but it also piles up much more infectious waste.
That means some hospitals, like LDS, have incinerators that are adequate for their own wastes but not big enough to handle the ballooning volume from outside clinics and doctors' offices. So who takes care of them?
That's where BFI Medical Waste Systems steps in. Or, rather, it rolls up in its specially equipped, marked trucks.
BFI, at 3765 W. 21st South, apparently is Utah's only commercial operation that hauls away infectious waste for disposal. It is a national company, a division of Browning-Ferris Industries, based in Houston.
Susan Jones, spokeswoman for BFI's Salt Lake operation, said she has heard of Utahns coming into contact with contaminated waste.
"In the downtown area there are transients and people looking for drug supplies."
Also, animals and children get into waste dumpsters that may have infectious material in them.
Another problem is that "the solid-waste haulers are exposed to it, as are landfill workers."
Even hospital incinerators aren't always the answer, she maintains. "Some of them have had some difficulty. They've been cited for pollution violations."
If the EPA were to tighten its standards, "a number of these incinerators would not pass, and they would have to install expensive scrubbing equipment."
Hospitals often are in residential areas. "Many of the hospital incinerators out there are older." Jones said some are in excellent condition, but some are not.
Health-care facilities generally agree to follow their own guidelines about disposal. They don't want to face the liability that would occur if they were responsible for spreading disease through contaminated material. But what are they to do?
BFI offers an alternative to both on-site incineration and just throwing infectious material away.
Companies contracting with BFI - 42 clients along the Wasatch Front - are supplied with double-layer red bags and red "sharps containers" to hold needles and glass devices.
BFI will pick up the waste on a regular schedule. How often "really varies," Jones said.
Utah doesn't yet have any regulations on how long infectious waste can be stored. BFI consults with its client and uses a common-sense approach to deciding how often to pick up the material, said Jones.
"It could be daily. Or it could be up to 90 days. It depends on the nature of the material and whether it can be safely stored at the site where it's generated."
A blood bank can't let waste blood sit around long, as it will quickly putrefy and grow dangerous organisms. But dry material, like empty syringes, can be kept longer.
The BFI truck has a "completely enclosed cab and truck boxes or storage areas (are) separate from each other. In other words, a van is not acceptable," Jones said.
In a van, the driver would be exposed to a risk of contamination. So the truck's storage area is completely enclosed, without openings.
After the truck makes its pickup rounds, which take a few hours, the waste is taken to BFI's cold-storage facility and kept at 32 degrees. "It stays in cold storage right up to the time it's incinerated," she said.
"We maintain treatment plants using both the incineration and steam-sterilization method, throughout the country. They are all regionalized," Jones said.
BFI doesn't have a plant in Utah yet, so waste is freighted to an Arizona disposal plant in a refrigerated 40-foot tractor trailer truck. Like the truck that picks up waste from hospitals, it is marked with an international symbol that means it carries hazardous biological material.
"Also, our vehicles carry a decontamination spill kit," Jones said. "It's more than just a bottle of Clorox and some rubber gloves. It's rather sophisticated."
Several kinds of gloves are included, for example, because some decontaminants might dissolve certain types of gloves. The trucks pack absorbents, various kinds of decontaminants, a respirator and all types of protective gear. The crews are trained in cleaning up spills.
Jones thinks a spill is unlikely. In a company that ships millions of pounds of waste nationally every year, one spill a year would be a great concern.
"We just don't have problems like that," she said.